It's an inevitable comparison, but it needs to be made.
I have no cable TV, but I'm well aware of cable news' breathless coverage of Ebola. I know this because my mother lives in the same small town where the second nurse diagnosed with Ebola in the U.S. visited her fiancee, about a mile away. My mother is a retired woman with way too much time to watch CNN and hyperventilate. Fortunately, she came down on the side of not wearing a mask and gloves to the supermarket. And she anticipated my recommendationt: turn off the news.
Ebola is a crisis in three countries in Africa. Ebola could be a crisis in the U.S., not because it's easily spread but because of the stunning revelation that hospitals and even those institutions we've come to trust (the CDC) had a major fuck up in the first go-round this month. I'd like to not jump to the conclusion that our institutions could not handle an outbreak in the (let's hope) highly unlikely event of one. But I see some parallels to how the U.S. responded (and didn't respond, at first) to HIV/AIDS. More after that orange cloud fence.
If I were my current age in the early 80s, I would be, I hope, enraged by exchanges like this, the first time Reagan's press secretary, Larry Speaks, addresses AIDS publicly.
Q: Larry, does the President have any reaction to the announcement—the Centers for Disease Control in Atlanta, that AIDS is now an epidemic and have over 600 cases?
MR. SPEAKES: What’s AIDS?
Q: Over a third of them have died. It’s known as “gay plague.” (Laughter.) No, it is. I mean it’s a pretty serious thing that one in every three people that get this have died. And I wondered if the President is aware of it?
MR. SPEAKES: I don’t have it. Do you? (Laughter.)
Q: No, I don’t.
MR. SPEAKES: You didn’t answer my question.
Q: Well, I just wondered, does the President—
MR. SPEAKES: How do you know? (Laughter.)
Q: In other words, the White House looks on this as a great joke?
MR. SPEAKES: No, I don’t know anything about it, Lester.
Q: Does the President, does anybody in the White House know about this epidemic, Larry?
MR. SPEAKES: I don’t think so. I don’t think there’s been any—
Q: Nobody knows?
MR. SPEAKES: There has been no personal experience here, Lester.
Q: No, I mean, I thought you were keeping—
MR. SPEAKES: I checked thoroughly with Dr. Ruge this morning and he’s had no—(laughter)—no patients suffering from AIDS or whatever it is.
Q: The President doesn’t have gay plague, is that what you’re saying or what?
MR. SPEAKES: No, I didn’t say that.
Q: Didn’t say that?
MR. SPEAKES: I thought I heard you on the State Department over there. Why didn’t you stay there? (Laughter.)
Q: Because I love you, Larry, that’s why. (Laughter.)
MR. SPEAKES: Oh, I see. Just don’t put it in those terms, Lester. (Laughter.)
Q: Oh, I retract that.
MR. SPEAKES: I hope so.
Har har, indeed.
I'm a real man so don't you try to kiss me, and aren't those dead homos a scream?
The only thing keeping me from puking at reading this exchange is knowing that at least such open homophobia from a public figure would not be tolerated. Not even from a Republican. The public outcry would be too great. 1982 seems as far removed from today as 1492 in terms of gay rights.
One more thing needs to be said about Reagan's disastrous stonewalling of anything that could have prevented any those deaths. The Surgeon General at that time, Dr C. Everett Koop could have worked with the CDC could deliver an appropriate prevention program, but Koop was forbidden to say anything about the disease for nearly six years, until he broke ranks with Reagan and issued a Surgeon General's report in October 1986. For that, Koop was attacked within the Administration. Because... icky gays?
Today we have a President who has spoken about Ebola. Obama hired a (probably) do-nothing Czar, but he's taking action, after one American has died. Unlike Reagan who didn't utter the word AIDS until, if memory serves, six years into the crisis, and after about 20,000 had died. At this point an estimated 43 million have died from AIDS-related causes. And they're still dying. But if we had a response as rapid to HIV/AIDS 30-some years ago as we have today with Ebola, that number of deaths would be dramatically lower.
At this point I need to say that it's too bad I don't believe in hell. Because I would be delighted to think there is a special place in it for Reagan.
If I were my age now back in the 80s, I like to think I would have joined Act Up, whether I were directly affected by AIDS or not. They and the more buttoned down offshoot, Treatment Action Group, which still exists today, moved mountains.
The biggest mountains were the FDA and NIH.
A little history. Act Up was not just angry people making noise and staging die-ins. They were citizens educating themselves about how drugs are developed, everything the average joe didn't need or want to know. They had to know, because their lives depended on it. Everything from antiviral medications, clinical-trial protocols, about the FDA approval process. They pushed the FDA to make trials less restrictive, and make the process much faster by actually talking with scientists and policy makers as equals (once they got their attention from the mass protests).
Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, has been quoted as saying Act Up leaders cracked open the opaque process of drug development, altered the patient-doctor relationship and changed the whole face of advocacy.
If you're interested in AIDS activism in the 80s, check out the fantastic documentary, How to Survive a Plague.
And what the activists of the 80s and 90s accomplished can be useful in other epidemics, pandemics and plagues. Like Ebola. The greatest legacy of Act Up is now the openness to using experimental treatments and vaccines.
But there may be lessons the world didn't learn from HIV/AIDS.
I began reporting on HIV/AIDS in 1998, two years after the first truly lifesaving meds were introduced, after the disease had morphed from a primarily gay white man's disease to one whose face was darker, poorer, more heterosexual and increasingly, African.
Africa, the continent that can least afford to combat another infectious disease. Not with their infrastructures. Not without help. At this point, I hope you don't mind if I give a shout out to George W. Bush. His Emergency Plan For AIDS Relief (PEPFAR) did quite a lot of good for health workers and people with HIV/AIDS in Africa. I'll give credit where it's due. It may have been the best thing he did in office.
Okay, I need to wrap this up and get to my final point. Lessons not learned. While the U.S. may skate through this crisis, what's becoming clear is that we, just like Africa, do not have a good enough rapid response system. The U.S. was caught flat footed on this. Noisy and shrill round-the-clock cable news coverage aside, there are some reasons to be concerned about future viruses that may be easier to spread than HIV or Ebola.
This week on the excellent podcast Decode DC, Mark Harrington, director of the Treatment Action Group, said that in the world's poorest countries there isn't a good rapid response system and that outbreaks are going to keep happening, whether its Ebola or something even more deadly and easier to catch. He knows of what he speaks.
And if the next epidemic starts in another poor region, countries that are most able to help, at least financially, are least likely to take it seriously. Consider that thousands had died in Africa of Ebola before the American media began paying attention. It wasn't until an American contracted it that the media took notice. Until then, it was "just in Africa." Just like in the 80s, when the plague was just affecting gay men. Easy to ignore, apparently. But the health of marginalized people affects everyone, and not only when TV news says it's so.
Canada is shipping an experimental Ebola vaccine to Africa. Only six months or so after the latest outbreak began. Not bad, compared to the early non-response to HIV/AIDS. At least not until you learn that there have been smaller Ebola outbreaks going back to 1976.
BTW, there is some good news amid the scare. Sunday was the last day of the quarantine for the family of Thomas Eric Duncan.